Provider Demographics
NPI:1497438915
Name:MODEL HOMES GROUP HOMES & ASSOCIATES LLC
Entity Type:Organization
Organization Name:MODEL HOMES GROUP HOMES & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER NURSE
Authorized Official - Prefix:
Authorized Official - First Name:YHANEKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-315-7936
Mailing Address - Street 1:6715 W PHILADELPHIA DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-9490
Mailing Address - Country:US
Mailing Address - Phone:317-315-7936
Mailing Address - Fax:
Practice Address - Street 1:6715 W PHILADELPHIA DR
Practice Address - Street 2:
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-9490
Practice Address - Country:US
Practice Address - Phone:317-315-7936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care